title: [The pattern of central nervous system lesions in HIV-infected patients of the specialized unit in infectious disease hospital].
abstract: OBJECTIVE
  To define the incidence and features of brain lesion (BL) in HIV-infected inpatients.
  
  
  METHODS
  Four hundred and fifty-eight patients with Stage 4B HIV infection (AIDS) and central nervous system (CNS) lesion admitted to Infectious Diseases Hospital Two, Moscow, were followed up in 2003-2009. The authors used cerebrospinal fluid (CSF) microscopic and bacteriological assays for DNA of T. gondii, M. tuberculosis, herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), HSV type 6, and varicella-zoster virus, Cr. neoformans, C. albicans, C. glabrata, and C. krusei. Blood and CSF were tested for IgM and IgG T. gondii antibodies; brain magnetic resonance imaging was carried out.
  
  
  RESULTS
  In patients with late-stage HIV infection, the principal cause of neurological diseases was cerebral toxoplasmosis (34.7% of BL cases) and a generalized process involving the brain, lung, heart, liver, and eyes in 11.5%. There was commonly cerebral toxoplasmosis concurrent with CMV infection with clinical manifestations. 16-32% of the inpatients developed tuberculosis meningoencephalitis that was a manifestation of hematogenous disseminated tuberculosis involving the lung. There was a rise in the incidence of cancers (brain lymphomas, astrocytomas) running with CNS lesion. Mental disorders progressing to dementia were a distinctive property of CMV ventriculoencephalitis, one of the leading factors in the development of AIDS dementia complex. Molecular diagnostic techniques are needed to ascertain the etiology of BL in HIV infection.
  
  
  CONCLUSIONS
  The CSF test for DNA of causative agents is a specific and most sensitive method for diagnosing a relevant CNS lesion.
authors.forename: A B
authors.initials: AB
authors.lastname: Peregudova
authors.forename: V I
authors.initials: VI
authors.lastname: Shakhgil'dian
authors.forename: O O
authors.initials: OO
authors.lastname: Tsvetkova
authors.forename: T N
authors.initials: TN
authors.lastname: Ermak
authors.forename: B M
authors.initials: BM
authors.lastname: Gruzdev
authors.forename: M V
authors.initials: MV
authors.lastname: Iuditskiĭ
authors.forename: O A
authors.initials: OA
authors.lastname: Tishkevich
authors.forename: O Iu
authors.initials: OIu
authors.lastname: Shipulina
authors.forename: M V
authors.initials: MV
authors.lastname: Al'vares Figeroa
authors.forename: A P
authors.initials: AP
authors.lastname: Safonova
authors.forename: E A
authors.initials: EA
authors.lastname: Dolgova
authors.forename: D B
authors.initials: DB
authors.lastname: Goncharov
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D000328:Adult; D000368:Aged; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006748:Hospital Departments; D006760:Hospitalization; D006763:Hospitals, Chronic Disease; D006786:Hospitals, Urban; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009031:Moscow; D055815:Young Adult